Maddox D A, Bennett C M, Deen W M, Glassock R J, Knutson D, Brenner B M
J Clin Invest. 1975 Jun;55(6):1315-25. doi: 10.1172/JCI108051.
We have recently shown that in the early autologous phase of nephrotoxic serum nephritis (NSN) single nephron glomerular filtration rate is unchanged from values in normal hydropenic control rats, but that single nephron filtration fraction and efferent arteriolar oncotic pressure (piE) are reduced because of a marked reduction in the glomerular capillary ultrafiltration coefficient. The present study was undertaken to examine the influence of this decline in piE as well as the other known determinants of peritubular capillary fluid exchange on absolute proximal fluid reabsorption (APR) in NSN. The findings indicate that APR and proximal fractional reabsorption are reduced significantly in NSN, relative to values in a separate group of age and weight-matched normal hydropenic control rats studied concurrently. In addition to the measured decline in piE, efferent arteriolar plasma flow (Qe) and peritubular capillary hydraulic pressure (Pc) were found to increase significantly, while interstitial oncotic pressure, estimated from hilar lymph, was not significantly different from values in control rats. Using a mathematical model of peritubular capillary fluid uptake we found that, assuming that the capillary permeability-surface area product and interstitial hydraulic pressure are unchanged in NSN, the observed changes in piE and Pc are sufficient to offset the effect of the increase in QE, yielding a calculated reduction in APR of approximately 4 nl/min, in excellent agreement with the observed mean decline of 4.1 nl/min. These findings suggest that control of APR in NSN is mediated by the same factors that regulate APR under normal physiological conditions, namely, the imbalance of forces governing peritubular capillary uptake of isotonic reabsorbate.
我们最近发现,在肾毒性血清性肾炎(NSN)的早期自体阶段,单个肾单位的肾小球滤过率与正常禁水对照大鼠的值相比没有变化,但单个肾单位的滤过分数和出球小动脉血浆胶体渗透压(πE)降低,这是由于肾小球毛细血管超滤系数显著降低所致。本研究旨在探讨πE下降以及其他已知的肾小管周围毛细血管液体交换决定因素对NSN中近端绝对液体重吸收(APR)的影响。研究结果表明,与同时研究的另一组年龄和体重匹配的正常禁水对照大鼠相比,NSN中的APR和近端分数重吸收显著降低。除了测量到的πE下降外,还发现出球小动脉血浆流量(Qe)和肾小管周围毛细血管液压(Pc)显著增加,而根据肾门淋巴估计的间质胶体渗透压与对照大鼠的值没有显著差异。使用肾小管周围毛细血管液体摄取的数学模型,我们发现,假设NSN中毛细血管通透表面积乘积和间质液压不变,观察到的πE和Pc变化足以抵消QE增加的影响,计算得出APR降低约4 nl/min,与观察到的平均下降4.1 nl/min非常一致。这些发现表明,NSN中APR的控制是由正常生理条件下调节APR的相同因素介导的,即控制肾小管周围毛细血管对等渗重吸收液摄取的力量失衡。